title: Relationship between ApoE, MRI findings, and cognitive function in the Cardiovascular Health Study.
abstract: OBJECTIVE
  We determined the relationship between apolipoprotein (Apo)E, MRI, and low cognitive scores.
  
  
  METHODS
  The relationship between age, education, ApoE genotype, MRI examination of the brain, subclinical and clinical cardiovascular disease, and low (<80) score on the Modified Mini-Mental State Examination (3MSE, as modified by Teng and Chui) was evaluated for 3469 black and white participants in the Cardiovascular Health Study (CHS) in years 5 and 6 of the study. The participants were followed for up to 3 years.
  
  
  RESULTS
  The prevalence of scores <80 in years 5 and 6 of the CHS was 8.2% for participants without and 20.4% for those with prior history of stroke. Age, race, and education were important determinants of low 3MSE scores. The prevalence of ApoE-4 (odds ratio [OR], 1.6 [1.1 to 2.1]) was directly related to scores <80, as was high ventricular volume (OR, 1.6 [1.2 to 2.3]), high white matter grade (OR, 1.4 [1.1 to 1.9]), and infarctlike lesions (OR, 1.6 [1.2 to 2.1]) on the MRI in the multivariate analysis. A five-point or greater decline in scores over up to 3 years was more often observed for participants with low 3MSE scores at year 5, at older ages, with lower education, and experiencing incident stroke (OR, 3.6 [1.2 to 10.6]), ApoE-4 genotype (OR, 1.8 [1.4 to 2.3]), and with MRI findings of high ventricular volume (OR, 2.0 [1.5 to 2.7]), and infarctlike lesions (OR, 1.2 [0.9 to 1.5]).
  
  
  CONCLUSIONS
  These results demonstrate that vascular changes on MRI, measures of brain atrophy, ApoE-4, and age, education, and race are associated with low cognitive scores among older individuals. The MRI of the brain provides valuable information related to cognitive tests and decline over time. The potential exists for using MRI measurements to identify high-risk individuals for dementia and to test potential interventions to reduce the risk of dementia.
authors.affiliation: University of Pittsburgh, Pa 15261, USA. kuller+@pitt.edu
authors.forename: L H
authors.initials: LH
authors.lastname: Kuller
authors.forename: L
authors.initials: L
authors.lastname: Shemanski
authors.forename: T
authors.initials: T
authors.lastname: Manolio
authors.forename: M
authors.initials: M
authors.lastname: Haan
authors.forename: L
authors.initials: L
authors.lastname: Fried
authors.forename: N
authors.initials: N
authors.lastname: Bryan
authors.forename: G L
authors.initials: GL
authors.lastname: Burke
authors.forename: R
authors.initials: R
authors.lastname: Tracy
authors.forename: R
authors.initials: R
authors.lastname: Bhadelia
mesh_terms: D000368:Aged; D001057:Apolipoproteins E / Q000097:blood / Q000235:genetics*; D044383:Black People / Q000235:genetics; D001921:Brain / Q000033:anatomy & histology* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002544:Cerebral Infarction / Q000453:epidemiology; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology*; D005260:Female; D005838:Genotype; D006304:Health Status; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012737:Sex Factors; D014481:United States; D044465:White People; D001741:Black or African American
chemical_list: D001057:Apolipoproteins E